A nurse in a prenatal clinic is completing a skin assessment of a client who is in the second trimester. Which of the following findings should the nurse expect? (Select all that apply.)

Explanation:

A. Unilateral, cramp-like abdominal pain.

This is a typical manifestation of an ectopic pregnancy. The pain is often localized to one side of the lower abdomen and may be cramp-like or sharp. It occurs due to the stretching and irritation of surrounding structures, such as the fallopian tube, as the pregnancy grows outside of the uterus.

B. Severe nausea and vomiting.

While nausea and vomiting can occur during pregnancy, especially in the first trimester (morning sickness), they are not specific manifestations of an ectopic pregnancy. Severe nausea and vomiting are more commonly associated with conditions like hyperemesis gravidarum, but they are not indicative of an ectopic pregnancy.

C. Large amount of vaginal bleeding.

Vaginal bleeding can occur in ectopic pregnancies, but it is typically not a large amount compared to the bleeding seen in a miscarriage or other complications. Ectopic pregnancy bleeding is often lighter and may be accompanied by spotting or brownish discharge. However, significant vaginal bleeding is not a consistent manifestation of an ectopic pregnancy.

D. Uterine enlargement greater than expected for gestational age.

In an ectopic pregnancy, the fertilized egg implants outside of the uterus, so there is no uterine enlargement as expected in a normal intrauterine pregnancy. Therefore, uterine enlargement greater than expected for gestational age would not be consistent with an ectopic pregnancy.

Explanation:

A. "Don't worry. You will be fine once the baby is born."

This response may inadvertently dismiss the client's feelings of doubt and uncertainty. It assumes that the client's concerns will automatically resolve after childbirth, which may not be the case for everyone. It lacks acknowledgment of the client's current emotional state and does not offer meaningful support or guidance.

B. "Ambivalent feelings are quite common for women early in pregnancy."

This response acknowledges the client's feelings of doubt and uncertainty as valid and common experiences during early pregnancy. It normalizes her emotions, letting her know that she is not alone in feeling this way. By providing this validation, the nurse creates a supportive environment where the client can feel understood and accepted.

C. "Perhaps you should see a counselor to discuss these feelings further."

Suggesting counseling is a proactive and supportive approach. It recognizes that the client's emotions are complex and may benefit from professional guidance. Counseling offers a safe space for the client to explore her feelings, understand their root causes, and develop coping strategies. It demonstrates the nurse's commitment to the client's emotional well-being and encourages seeking help when needed.

D. "Have you spoken to your mother about these feelings?"

While seeking support from family members can be valuable, this response may not fully address the client's emotional needs. It assumes that talking to her mother will automatically resolve her concerns, which may not always be the case. Additionally, some clients may prefer discussing sensitive issues with a neutral third party or a trained counselor who can offer unbiased support and guidance.